A Conversation With Phyllis Timlin, R.N. Owner of 'At Home Senior Care Of Broward'

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A.   Often seniors reject the idea of a stranger coming into their home because they recognize the reality that their independence and personal privacy may now be compromised. I also encounter the perception that a care giver might mistreat or act abusively to a gay patient.  Our home care agency has been serving the local LGBT for over 10 years. I have personally been involved in this area of health care as an R.N. for over 25 years.  We pride ourselves in assigning caregivers who have a proven track record of health care in the LGBT community. My responsibility is to be hands on, recruiting personnel who are demonstratively dedicated to serving this community.

My LGBT patient/clients have historically drawn from word of mouth referrals, gay members of my own close friends and family, and social service professionals who have experienced our sensitivity to LGBT home health care issues.

Q.    When a member of the LGBT community approaches you seeking home health care what is your protocol? 

A.     My job initially is to be a good listener. Initially, a prospective patient/client (or) a family member interviews me. My goal is to learn what a prospective client is seeking. Clients I've been responsible for through the years, have a unique set of health issues. My love is to find the perfect care giver for each client. My listening abilities must be coupled with intuition. Initially, people aren't always candid. I engage in a thorough assessment. I generally ask polite but insightful questions designed to provoke truth. As I've said, assigning the right care giver is dependent upon understanding the client's medical needs and unique personal requirements.  Client's preferences for a care giver concern age, gender, color and ethnicity. It some cases I've sent one, two or three care givers to a patient until the match works out…and it always does .

Q.     How do clients find you?

A.     "Are you gay?" Often a prospective client from the LGBT community makes that inquiry of me in a first phone call. My sexual preference obviously has no bearing on my qualifications to offer excellent care giving services. The question, however, is indicative of someone searching for a care giver with a sensitive understanding of his or her care giver needs. Through the years I have been fortunate to build my reputation by being hands on. When issues arise, I normally am the one who answers the phone and goes to the home when necessary to solve a problem. I have grown my  home health care business by a strong word of mouth following.

It only takes one integrity-related misstep to ruin a reputation. I have been sending care givers to the local LGBT community for several years. I have been attending community events over the years with a close relative. Recently one of my ongoing gay clients asked me if I ever advertised in his community. I indicated that I never have. He suggested I let people know of my experience with LGBT home health care issues. So here I am!Q.     How do they know if your personnel are qualified?

My responsibility is to constantly verify the training and experience of home health care givers that I assign. Florida Statutes require a licensed caregiver to take required credit hours of HIV/AIDS training. There is a yearly educational updating requirement which my care givers must attend. Additionally, I observe a Florida Statute's requirement that each care giver take a certified course in OSHA universal biological hazardous waste disposal. This insures care givers are aware of when to wear a mask, gown and when this is not necessary. Finally, a care giver in my organization must have attended an accredited school recognized by the Florida Department of Professional Regulations. Many of my care givers have been with me for since day one which is a powerful testament to my obsession for care giver excellence. But, it takes more than fulfilling legal requirements. Recently, an adorable French movie “The Intouchables”, delivered a great message about the subject of care giving. Namely, it takes more than showing up with credentials. A quality care giver needs to have heart and passion for what they do! I try to assign care givers who possess that special trait.  We also verify all their documents, national fingerprint ,drivers license screening and insurance.

Q.    In your care giver experience with patient/clients from the LGBT community is there any specific issue(s) that you have encountered unique to that demographic?

A.     Anyone suddenly in need of a home health care giver as I've mentioned earlier deals with this experience differently. I have observed in this community a more pronounced craving for privacy. I am not a social worker. My guess is that older gays who may have kept their sexual preference to themselves over the years and must now allow a stranger into their home, face a significant dilemma. I have seen individuals in this context suffering from loneliness and resulting depression.

Imagine elder partners and same sex spouses that have been together for 40 years, suddenly encountering the unexpected need for a care giver. All of a sudden they face the prospect of revealing a heretofore personal lifestyle. I have come across this issue repeatedly. I am observant of strict HIPPA statutes that forbid sharing medical issues that would otherwise compromise individual privacy. I view my client's lifestyle with the same level of guarded privacy. Unfortunately, a senior who suffers Alzheimer’s, dementia, Parkinson's disease, stroke, and other aging illnesses cuts across all demographics. As more and more baby boomers approach senior status and resulting old age disabilities, the availability of being cared for in one's home is a desirable choice made more comforting by a qualified care giver.

Q.     Many Seniors encountering the prospect of home health care are intimidated by perceived high costs of that service. How expensive are these costs?

A.      Home health care costs can be relatively expensive unless there has been some wise financial planning done earlier in one's life. Long term care insurance easily is the ideal solution which normally covers 100% of the costs of quality home health care. That being said, I flexibly schedule an hourly rate depending on the level of care necessary. My goal is to tailor the hours per week with an affordable schedule. This economically allows a care giver to accomplish tasks such as light housekeeping, meal preparation, hygiene issues, and personal travel needs such as food shopping and doctor office visits. Clients may require a few hours a day or 24/7 care. Sometimes a care giver's duties are what we call respite care. This essentially is relief time for a partner or spouse who needs to attend to matters outside the home and fear leaving their loved one alone. Incidentally, there is a home health care pension available from the VA (called aid and attendance pension) if a plus 65 year old Senior has served in the military during a conflict and is worth less than $80,000.00 not including their house and car. The amount per month available can be up to $1780.00.  A Veteran's spouse can receive up to $1000.00 per month for home health care. We do accept long term care insurance,veteran benefits ,private pay and selected Medicaid waiver benefits.

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Greg Kabel